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Acute Cardiovascular Effects of Firefighting and Active Cooling During Rehabilitation

Burgess, Jefferey L. MD, MS, MPH; Duncan, Michael D. BA; Hu, Chengcheng PhD; Littau, Sally R. BS; Caseman, Delayne MPH; Kurzius-Spencer, Margaret MS, MPH; Davis-Gorman, Grace BS; McDonagh, Paul F. PhD

Journal of Occupational and Environmental Medicine: November 2012 - Volume 54 - Issue 11 - p 1413–1420
doi: 10.1097/JOM.0b013e3182619018
Original Articles

Objectives: To determine the cardiovascular and hemostatic effects of fire suppression and postexposure active cooling.

Methods: Forty-four firefighters were evaluated before and after a 12-minute live-fire drill. Next, 50 firefighters performing the same drill were randomized to undergo postfire forearm immersion in 10°C water or standard rehabilitation.

Results: In the first study, heart rate and core body temperature increased and serum C-reactive protein decreased but there were no significant changes in fibrinogen, sE-selectin, or sL-selectin. The second study demonstrated an increase in blood coagulability, leukocyte count, factors VIII and X, cortisol, and glucose, and a decrease in plasminogen and sP-selectin. Active cooling reduced mean core temperature, heart rate, and leukocyte count.

Conclusions: Live-fire exposure increased core temperature, heart rate, coagulability, and leukocyte count; all except coagulability were reduced by active cooling.

From the Mel and Enid Zuckerman College of Public Health (Drs Burgess and Hu and Mr Duncan, Ms Littau, Ms Caseman, and Ms Kurzius-Spencer) and Sarver Heart Center, University of Arizona, Tucson, Ariz (Ms Davis-Gorman and Dr McDonagh)

Address correspondence to: Jefferey L. Burgess, MD, MS, MPH, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Tucson, AZ 85724 (

This study was supported by the Federal Emergency Management Assistance to Firefighters grant EMW-2007-FP-01499; the National Institute for Environmental Health Sciences Southwest Environmental Health Sciences Center (SWEHSC) grant ES006694; and the Sarver Heart Center Hudson/Lovaas Endowment.

The authors declare no conflict of interest.

©2012The American College of Occupational and Environmental Medicine